Healthcare Provider Details

I. General information

NPI: 1750738647
Provider Name (Legal Business Name): AHARON ELIEZER BENELYAHOO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E 38TH ST FL 14
NEW YORK NY
10016-2708
US

IV. Provider business mailing address

240 E 38TH ST FL 14
NEW YORK NY
10016-2708
US

V. Phone/Fax

Practice location:
  • Phone: 212-201-1004
  • Fax:
Mailing address:
  • Phone: 212-201-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number302433
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: